PDF(Pubmed)
Abstract：
UNASSIGNED: Surgical reconstruction is often necessary for severe tracheobronchial stenosis resulting from tuberculosis (TB). However, the long-term efficacy of this approach remains unclear. This study investigated the safety and long-term outcomes of surgery for severe post-TB tracheobronchial stenosis.
UNASSIGNED: We conducted a retrospective study of 48 patients with severe post-TB tracheobronchial stenosis who underwent surgical reconstruction between 2015 and 2018 in a TB-endemic region. Pre- and postoperative evaluations included Karnofsky performance status, modified Medical Research Council (mMRC) dyspnea scale, spirometry, chest computed tomography (CT) scan, and bronchoscopy. The primary outcome was intervention-requiring restenosis over the long term.
UNASSIGNED: The mean patient age was 30.6±9.9 years, with 91.7% females. Airway fibrosis was the predominant lesion (93.8%), affecting the bronchi (93.8%) and trachea (6.2%). All the patients underwent resection and anastomosis, and 56.2% required lobectomy. Postoperative complications occurred in 13 patients (27.1%), with prolonged air leaks being the most prevalent (12.5%). All complications resolved with conservative management. Significant improvements in performance status, dyspnea, and lung function were observed postoperatively and sustained for over 5 years. Within a median follow-up of 69 months, five cases of intervention-requiring restenosis occurred within the first year. The freedom from restenosis rate was 90% from 1 year onwards.
UNASSIGNED: Surgical reconstruction is safe and effective in treating severe post-TB tracheobronchial stenosis. Larger studies are required to validate these findings.
UNASSIGNED: We conducted a retrospective study of 48 patients with severe post-TB tracheobronchial stenosis who underwent surgical reconstruction between 2015 and 2018 in a TB-endemic region. Pre- and postoperative evaluations included Karnofsky performance status, modified Medical Research Council (mMRC) dyspnea scale, spirometry, chest computed tomography (CT) scan, and bronchoscopy. The primary outcome was intervention-requiring restenosis over the long term.
UNASSIGNED: The mean patient age was 30.6±9.9 years, with 91.7% females. Airway fibrosis was the predominant lesion (93.8%), affecting the bronchi (93.8%) and trachea (6.2%). All the patients underwent resection and anastomosis, and 56.2% required lobectomy. Postoperative complications occurred in 13 patients (27.1%), with prolonged air leaks being the most prevalent (12.5%). All complications resolved with conservative management. Significant improvements in performance status, dyspnea, and lung function were observed postoperatively and sustained for over 5 years. Within a median follow-up of 69 months, five cases of intervention-requiring restenosis occurred within the first year. The freedom from restenosis rate was 90% from 1 year onwards.
UNASSIGNED: Surgical reconstruction is safe and effective in treating severe post-TB tracheobronchial stenosis. Larger studies are required to validate these findings.
摘要：
■对于由结核（TB）引起的严重气管支气管狭窄，通常需要手术重建。然而,这种方法的长期疗效尚不清楚.这项研究调查了手术治疗结核病后严重气管支气管狭窄的安全性和长期结果。
■我们对2015年至2018年在结核病流行地区接受手术重建的48例重度结核病后气管支气管狭窄患者进行了回顾性研究。术前和术后评估包括Karnofsky表现状态，改良医学研究理事会(mMRC)呼吸困难量表，肺活量测定,胸部计算机断层扫描(CT)扫描,和支气管镜检查。主要结果是长期需要干预的再狭窄。
■患者平均年龄为30.6±9.9岁，女性占91.7%。气道纤维化是主要病变（93.8%），影响支气管（93.8%）和气管（6.2%）。所有患者均行切除吻合术，56.2%需要肺叶切除术。术后并发症13例(27.1%),长期漏气是最普遍的(12.5%)。所有并发症均通过保守治疗解决。性能状态的显著改善，呼吸困难,术后观察肺功能，持续5年以上。在69个月的中位随访时间内，在第一年内发生了5例需要干预的再狭窄.从1年开始，再狭窄的发生率为90％。
■手术重建治疗肺结核后严重气管支气管狭窄是安全有效的。需要更大规模的研究来验证这些发现。
■我们对2015年至2018年在结核病流行地区接受手术重建的48例重度结核病后气管支气管狭窄患者进行了回顾性研究。术前和术后评估包括Karnofsky表现状态，改良医学研究理事会(mMRC)呼吸困难量表，肺活量测定,胸部计算机断层扫描(CT)扫描,和支气管镜检查。主要结果是长期需要干预的再狭窄。
■患者平均年龄为30.6±9.9岁，女性占91.7%。气道纤维化是主要病变（93.8%），影响支气管（93.8%）和气管（6.2%）。所有患者均行切除吻合术，56.2%需要肺叶切除术。术后并发症13例(27.1%),长期漏气是最普遍的(12.5%)。所有并发症均通过保守治疗解决。性能状态的显著改善，呼吸困难,术后观察肺功能，持续5年以上。在69个月的中位随访时间内，在第一年内发生了5例需要干预的再狭窄.从1年开始，再狭窄的发生率为90％。
■手术重建治疗肺结核后严重气管支气管狭窄是安全有效的。需要更大规模的研究来验证这些发现。
